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J. pediatr. (Rio J.) ; 92(6): 624-630, Nov.-Dec. 2016. tab, graf
Article in English | LILACS (Americas) | ID: biblio-829127


Abstract Objective: Childhood obesity has been associated with metabolic syndrome and cardiovascular diseases. This study aimed to compare plasma levels of traditional metabolic markers, adipokines and soluble tumor necrosis factor receptor type 1 (sTNFR1) in overweight, obese and lean children. We also assessed the relationships of these molecules with classical metabolic risk factors. Methods: This study included 104 children and adolescents, which were grouped as: lean (n = 24), overweight (n = 30), and obese subjects (n = 50). They were subjected to anthropometrical, clinical and laboratorial measurements. All measurements were compared between groups. Correlation analyses were also performed to evaluate the association between clinical data, traditional metabolic markers, adipokines and sTNFR1. Results: Fasting glucose, insulin, homeostatic model assessment of insulin resistance (HOMA-IR), LDL-cholesterol and triglycerides were comparable in lean, overweight and obese subjects. Plasma levels of sTNFR1 were similar in lean and overweight subjects, but significantly increased in obese group. Leptin, adiponectin and resistin levels did not differ when overweight were compared to obese subjects. However, all adipokines differed significantly when lean subjects were compared to overweight and obese individuals. Plasma levels of adiponectin were negatively correlated with body mass index (BMI), whereas leptin, resistin and sTNFR1 concentrations positively correlated with BMI. Conclusion: Our results showed significant differences in circulating levels of the evaluated markers when lean, overweight and obese individuals were compared, suggesting that these biomarkers may change from lean to overweight and from overweight to obesity.

Resumo Objetivo: A obesidade na infância tem sido associada à síndrome metabólica e a doenças cardiovasculares. O objetivo deste estudo foi comparar níveis plasmáticos de marcadores metabólicos tradicionais, adipocinas e do receptor solúvel de fator de necrose tumoral tipo 1 (sTNFR1) em crianças com sobrepeso, obesas e magras. Também avaliamos as relações dessas moléculas com fatores de risco metabólico clássicos. Métodos: Este estudo incluiu 104 crianças e adolescentes, agrupados da seguinte forma: indivíduos magros (n = 24), com sobrepeso (n = 30) e obesos (n = 50). Eles foram submetidos a medições antropométricas, clínicas e laboratoriais. Todas as medições foram comparadas entre os grupos. Também foram feitas análises de correlação para avaliar a associação entre dados clínicos, marcadores metabólicos tradicionais, adipocinas e sTNFR1. Resultados: Glicemia de jejum, insulina, modelo de avaliação da homeostase da resistência à insulina (HOMA-IR), colesterol LDL e triglicerídeos foram comparáveis em indivíduos magros, com sobrepeso e obesos. Os níveis plasmáticos de sTNFR1 foram similares em indivíduos magros e com sobrepeso, porém significativamente maiores no grupo obeso. Os níveis de leptina, adiponectina e resistina não diferiram quando indivíduos com sobrepeso foram comparados aos obesos. Contudo, todas as adipocinas diferiram significativamente quando indivíduos magros foram comparados a indivíduos com sobrepeso e obesos. Os níveis plasmáticos de adiponectina estavam negativamente correlacionados ao índice de massa corporal (IMC), ao passo que as concentrações de leptina, resistina e sTNFR1 estavam positivamente correlacionadas ao IMC. Conclusão: Nossos resultados mostraram diferenças significativas nos níveis circulantes dos marcadores avaliados ao comparar indivíduos magros, com sobrepeso e obesos. Isso sugere que esses biomarcadores poderão mudar de indivíduos magros para indivíduos com sobrepeso e de indivíduos com sobrepeso para obesos.

Humans , Male , Female , Child , Adolescent , Receptors, Tumor Necrosis Factor, Type I/blood , Overweight/blood , Adipokines/blood , Pediatric Obesity/blood , Triglycerides/blood , Blood Glucose/analysis , Insulin Resistance , Biomarkers/blood , Body Mass Index , Cross-Sectional Studies , Fasting/blood , Cholesterol, LDL/blood
Braz. j. med. biol. res ; 48(12): 1101-1108, Dec. 2015. tab, graf
Article in English | LILACS (Americas) | ID: lil-762919


We aimed to evaluate the effects of aerobic exercise training (4 days) and metformin exposure on acute glucose intolerance after dexamethasone treatment in rats. Forty-two adult male Wistar rats (8 weeks old) were divided randomly into four groups: sedentary control (SCT), sedentary dexamethasone-treated (SDX), training dexamethasone-treated (DPE), and dexamethasone and metformin treated group (DMT). Glucose tolerance tests and in situ liver perfusion were undertaken on fasting rats to obtain glucose profiles. The DPE group displayed a significant decrease in glucose values compared with the SDX group. Average glucose levels in the DPE group did not differ from those of the DMT group, so we suggest that exercise training corrects dexamethasone-induced glucose intolerance and improves glucose profiles in a similar manner to that observed with metformin. These data suggest that exercise may prevent the development of glucose intolerance induced by dexamethasone in rats to a similar magnitude to that observed after metformin treatment.

Animals , Male , Glucose Intolerance/prevention & control , Hypoglycemic Agents/therapeutic use , Metformin/therapeutic use , Physical Conditioning, Animal/physiology , Blood Glucose/analysis , Dexamethasone/pharmacology , Fasting/blood , Glucose Tolerance Test , Glucocorticoids/pharmacology , Glucose Intolerance/chemically induced , Glucose/analysis , Hyperglycemia/therapy , Liver/chemistry , Perfusion , Random Allocation , Rats, Wistar , Swimming
Arch. endocrinol. metab. (Online) ; 59(5): 407-413, Oct. 2015. tab, graf
Article in English | LILACS (Americas) | ID: lil-764122


ObjectiveThere is a growing body of data supporting the association between diabetes and microcirculatory disfunction. We aimed to study e-selectin levels, and their associations with serum markers of inflammation and arterial stiffness in prediabetes and newly diagnosed diabetes patients in this study.Subjects and methodsSixty patients (25 females) with a newly established elevated fasting serum glucose [20 impaired fasting glucose (IFG), 20 impaired glucose tolerance (IGT), 20 newly diagnosed diabetes (T2DM)] and 17 healthy controls (13 females) were included in the study. Serum e-selectin and hs-CRP levels, and arterial stiffness parameters of the patients were studied.ResultsFasting serum glucose was the most important predictor of serum e-selectin levels. Pulse wave velocity and central aortic pressures were significantly higher in IFG, IGT and T2DM groups, compared to controls (p = 0.001, < 0.001, 0.013 and 0.015, 0.002, 0.009, respectively). The mean arterial pressure did not show any significant association with serum e-selectin and hs-CRP levels (β coefficient: 0.092, p = 0.358; and β coefficient: 0.189, p = 0.362, respectively).ConclusionPrediabetes patients have increasing e-selectin levels through the diagnosis of T2DM. E-selectin is associated with serum glucose levels. Prediabetic and newly diagnosed diabetics have higher arterial stiffness measurements. Serum e-selectin may be a good marker of endothelial inflammation and dysfunction increasing in parallel with serum glucose levels, predicting future cardiovascular events.

Adult , Aged , Female , Humans , Male , Middle Aged , C-Reactive Protein/analysis , /metabolism , E-Selectin/blood , Endothelium, Vascular/metabolism , Prediabetic State/metabolism , Vascular Stiffness/physiology , Biomarkers/blood , Blood Glucose/analysis , Case-Control Studies , /physiopathology , Endothelium, Vascular/physiopathology , Fasting/blood , Glucose Tolerance Test , Microcirculation , Pulse Wave Analysis , Prediabetic State/physiopathology , Risk Factors
Arch. argent. pediatr ; 113(3): e140-e144, jun. 2015. ilus
Article in Spanish | LILACS (Americas) | ID: lil-750471


Tanto el síndrome de hemihipertrofia como el cor triatriatum son patologías sumamente infrecuentes. La hemihipertrofia se define como el sobrecrecimiento completo o parcial de uno de los hemicuerpos. El cor triatriatum es una cardiopatía congénita caracterizada por una membrana que divide la aurícula izquierda en dos cámaras; si esta membrana tiene un orificio restrictivo, provoca obstrucción al pasaje sanguíneo desde las venas pulmonares hacia el ventrículo izquierdo, lo que genera hipertensión y edema pulmonar. En este contexto, el ductus arterioso permeable puede actuar como vía de descompresión del circuito pulmonar al permitir el pasaje sanguíneo desde la arteria pulmonar hacia la aorta. Presentamos a un paciente con diagnóstico de síndrome de Silver-Rusell (hemihipertrofia), cor triatriatum y ductus arterioso con flujo invertido. Hasta donde conocemos, esta asociación de patologías infrecuentes y forma de presentación no se han descrito anteriormente.

Hemihypertrophy syndrome and cor triatriatum are extremely rare pathologies. Hemihypertrophy is defined as complete or partial overgrowth of one of the hemibodies. Cor triatriatum is a congenital heart disease characterized by a membrane which separates the left atrium into two chambers; if that membrane has a restrictive hole, it causes obstruction to blood passage from the pulmonary veins into the left ventricle causing hypertension and pulmonary edema. In this context, the patent ductus arteriosus can act as a means of decompression of the pulmonary circuit, because it allows the blood passage from the pulmonary artery to the aorta. We report a patient with Silver-Rusell syndrome (hemihypertrophy), cor triatriatum and ductus arteriosus with reverse flow. To our knowledge, this association of rare pathologies and this clinical presentation have not been described previously.

Adult , Aged , Female , Humans , Male , Middle Aged , Blood Glucose/genetics , Fasting/blood , Age Factors , Body Mass Index , /genetics , Genotype , Glucose Intolerance/genetics , Polymorphism, Single Nucleotide/genetics
Rev. latinoam. enferm ; 23(1): 20-27, Jan-Feb/2015. tab
Article in English | LILACS (Americas), BDENF | ID: lil-742030


OBJECTIVE: to evaluate the indexes and the main factors associated with non-adherence to medication treatment for systemic arterial hypertension between urban and rural areas. METHOD: analytical study based on an epidemiological survey with a sample of 247 hypertensive residents of rural and urban areas, with application of a socio-demographic and economic questionnaire, and treatment adherence assessment. The Pearson's Chi-square test was used and the odds ratio (OD) was calculated to analyze the factors related to non-adherence. RESULTS: the prevalence of non-adherence was 61.9% and it was higher in urban areas (63.4%). Factors significantly associated with non-adherence were: male gender (OR=1.95; 95% CI 1.08-3.50), age 20-59 years old (OR=2.51; 95% CI 1.44-4.39), low economic status (OR=1.95; 95% CI 1.09-3.47), alcohol consumption (OR=5.92, 95% CI 1.73-20.21), short time of hypertension diagnosis (OR=3.07; 95% CI 1.35-6.96) and not attending the health service for routine consultations (OR=2.45; 1.35-4.42). CONCLUSION: the socio-demographic/economic characteristics, lifestyle habits and how to relate to health services were the factors that presented association with non-adherence regardless of the place of residence. .

OBJETIVO: avaliar os índices e os principais fatores associados a não adesão ao tratamento medicamentoso da hipertensão arterial sistêmica, entre área urbana e rural. MÉTODO: estudo analítico baseado em inquérito epidemiológico, realizado com amostra de 247 hipertensos moradores das áreas rural e urbana, com aplicação de questionário sociodemográfico, econômico e avaliação da adesão. Foi utilizado o teste quiquadrado de Pearson e calculado o Odds Ratio (OD) para análise dos fatores relacionados a não adesão. RESULTADOS: a prevalência da não adesão foi de 61,9%, sendo maior na área urbana (63,4%). Os fatores que apresentaram associação estatisticamente significativa com a não adesão foram: gênero masculino (OR=1,95; IC95% 1,08-3,50), faixa etária entre 20 e 59 anos (OR=2,51; IC95% 1,44-4,39), baixa classe econômica (OR=1,95; IC95% 1,09-3,47), etilismo (OR=5,92; IC 95% 1,73-20,21), tempo curto de diagnóstico de hipertensão (OR=3,07; IC95% 1,35-6,96) e não procura pelo serviço de saúde para consultas de rotina (OR=2,45; 1,35-4,42). CONCLUSÃO: as características sociodemográficas, econômicas, hábitos de vida e o modo de relacionar-se com os serviços de saúde foram os fatores que apresentaram associação com a não adesão, independentemente do local de residência. .

OBJETIVO: evaluar los índices y los principales factores asociados a la no adhesión al tratamiento medicamentoso de la hipertensión arterial sistémica entre área urbana y rural. MÉTODO: estudio analítico basado en investigación epidemiológica desarrollada con una muestra de 247 hipertensos moradores del área rural y urbana, con aplicación de un cuestionario sociodemográfico, económico y evaluación de la adhesión. Fue utilizado la prueba chi-cuadrado de Pearson y calculado el odds ratio (OD) para análisis de los factores relacionados a la no adhesión. RESULTADOS: la prevalencia de la no adhesión correspondió a 61,9%, siendo mayor en el área urbana (63,4%). Los factores que mostraron asociación estadísticamente significativa con la no adhesión fueron: género masculino (OR=1,95; IC95% 1,08-3,50), rango de edad entre 20 a 59 años (OR=2,51; IC95% 1,44-4,39), clase económica baja (OR=1,95; IC95% 1,09-3,47), etilismo (OR=5,92; IC 95% 1,73-20,21), tiempo corto de diagnóstico de hipertensión (OR=3,07; IC95% 1,35-6,96) y no procurar el servicio de salud para consultas de rutina (OR=2,45; 1,35-4,42). CONCLUSIÓN: las características sociodemográficas/económicas, hábitos de vida y el modo de relacionar con los servicios de salud fueron los factores que mostraron asociación con la no adhesión independientemente del local de residencia. .

Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Amino Acid Metabolism, Inborn Errors/complications , Genetic Predisposition to Disease/genetics , Proline Oxidase/deficiency , Schizophrenia , Vitamin D Deficiency/complications , Amino Acid Metabolism, Inborn Errors/blood , Fasting/blood , Models, Statistical , Mutation/genetics , Proline Oxidase/blood , Proline Oxidase/genetics , Proline/metabolism , Risk Factors , Schizophrenia/blood , Schizophrenia/etiology , Schizophrenia/genetics , Vitamin D/analogs & derivatives , Vitamin D/blood
Rev. bras. cir. cardiovasc ; 30(1): 63-69, Jan-Mar/2015. tab, graf
Article in English | LILACS (Americas) | ID: lil-742892


Introduction: In spite of its importance as an experimental model, the information on the great cardiac vein in pigs is sparse. Objective: To determine the morphologic characteristics of the great cardiac vein and its tributaries in pigs. Methods: 120 hearts extracted from pigs destined to the slaughterhouse with stunning method were studied. This descriptive cross-over study evaluated continuous variables with T test and discrete variables with Pearson χ square test. A level of significance P<0.05 was used. The great cardiac vein and its tributaries were perfused with polyester resin (85% Palatal and 15% Styrene) and then subjected to potassium hydroxide infusion to release the subepicardial fat. Calibers were measured, and trajectories and relations with adjacent arterial structures were evaluated. Results: The origin of the great cardiac vein was observed at the heart apex in 91 (76%) hearts. The arterio-venous trigone was present in 117 (97.5%) specimens, corresponding to the open expression in its lower segment and to the closed expression in the upper segment in the majority of the cases (65%). The caliber of the great cardiac vein at the upper segment of the paraconal interventricular sulcus was 3.73±0.79 mm. An anastomosis between the great cardiac vein and the middle cardiac vein was found in 59 (49%) specimens. Conclusion: The morphological and biometric characteristics of the great cardiac vein and its tributaries had not been reported in prior studies, and due to their similitude with those of the human heart, allows us to propose the pig model for procedural and hemodynamic applications. .

Introdução: Apesar de sua importância como um modelo experimental, a informação sobre a grande veia cardíaca em suínos é esparsa. Objetivo: Determinar as características morfológicas da grande veia cardíaca e suas tributárias em suínos. Métodos: Foram estudados 120 corações extraídos de suínos destinados para o matadouro com método de atordoamento. Este estudo descritivo cross-over avaliou variáveis contínuas com teste T e variáveis discretas com teste χ quadrado de Pearson. O nível de significância P<0,05 foi usado. A grande veia cardíaca e suas tributárias foram perfundidas com resina de poliéster (85% palatal e estireno de 15%) e, em seguida, submetidas à infusão de hidróxido de potássio para remover a gordura subepicardal. Os calibres foram medidos e trajetórias e relações com estruturas arteriais adjacentes foram avaliadas. Resultados: A origem da grande veia cardíaca foi observada no ápice do coração em 91 (76%) espécimes. O trígono arteriovenoso estava presente em 117 (97,5%) espécimes, correspondente à expressão aberta no seu segmento inferior e para a expressão fechada no segmento superior na maioria dos casos (65%). O calibre da grande veia cardíaca no segmento superior do sulco interventricular paraconal foi de 3,73±0,79 mm. Uma anastomose entre a grande veia cardíaca e da veia cardíaca média foi encontrada em 59 (49%) espécimes. Conclusão: As características morfológicas e biométricas da grande veia cardíaca e suas tributárias não haviam sido relatadas em estudos anteriores e, devido à sua semelhança com as do coração humano, nos permite propor o modelo porcino para procedimentos e aplicações hemodinâmicas. .

Aged , Female , Humans , Male , Middle Aged , Body Mass Index , Blood Glucose/metabolism , Blood Pressure/physiology , /blood , /genetics , Fasting/blood , /genetics , Genotype , Genetic Predisposition to Disease/genetics , Prospective Studies , Polymorphism, Single Nucleotide/genetics
Rev. méd. Chile ; 143(1): 112-115, ene. 2015. ilus
Article in Spanish | LILACS (Americas) | ID: lil-742559


Cystic degeneration of the popliteal artery is an uncommon cause of intermittent claudication. We report a 52 years old male consulting for intermittent claudication referred to the calf. The angiography showed a 93% stenosis in segment of 45 mm length of the left popliteal artery with a smooth surface, suggesting an extrinsic compression. A CT angiography of the lower limb suggested the presence of a cystic degeneration. The patient was operated and the middle third of the popliteal artery was excised. The pathological study of the surgical piece was informed as artery media cystic degeneration.

Female , Humans , Male , Middle Aged , Blood Glucose/analysis , Depressive Disorder/blood , Depressive Disorder/epidemiology , Diabetes Mellitus/blood , Diabetes Mellitus/epidemiology , Glycated Hemoglobin A/analysis , Aging/blood , Aging/psychology , Cross-Sectional Studies , England/epidemiology , Follow-Up Studies , Fasting/blood , Longitudinal Studies , Odds Ratio , Prospective Studies , Psychiatric Status Rating Scales/statistics & numerical data , Risk Factors
ABCD arq. bras. cir. dig ; 28(1): 40-43, 2015. tab
Article in English | LILACS (Americas) | ID: lil-742743


BACKGROUND: Bariatric surgery is effective treatment for weight loss, but demand continuous nutritional care and physical activity. They regain weight happens with inadequate diets, physical inactivity and high alcohol consumption. AIM: To investigate in patients undergoing Roux-Y-of gastroplasty weight regain, nutritional deficiencies, candidates for the treatment with endoscopic argon plasma, the diameter of the gastrojejunostomy and the size of the gastric pouch at the time of treatment with plasma. METHODS: A prospective 59 patients non-randomized study with no control group undergoing gastroplasty with recurrence of weight and candidates for the endoscopic procedure of argon plasma was realized. The surgical evaluation consisted of investigation of complications in the digestive system and verification of the increased diameter of the gastrojejunostomy. Nutritional evaluation was based on body mass index at the time of operation, in the minimum BMI achieved after and in which BMI was when making the procedure with plasma. The laboratory tests included hemoglobin, erythrocyte volume, ferritin, vitamin D, B12, iron, calcium, zinc and serum albumin. Clinical analysis was based on scheduled follow-up. RESULTS: Of the 59 selected, five were men and 51 women; were included 49 people (four men and 44 women) with all the complete data. The exclusion was due to the lack of some of the laboratory tests. Of this total 19 patients (38.7%) had a restrictive ring, while 30 (61.2%) did not. Iron deficiency anemia was common; 30 patients (61.2%) were below 30 with ferritin (unit); 35 (71.4%) with vitamin B12 were below 300 pg/ml; vitamin D3 deficiency occurred in more than 90%; there were no cases of deficiency of protein, calcium and zinc; glucose levels were above 99 mg/dl in three patients (6.12%). Clinically all had complaints of labile memory, irritability and poor concentration. All reported that they stopped treatment with the multidisciplinary ...

RACIONAL: A cirurgia bariátrica é tratamento efetivo para a perda ponderal, mas demanda cuidados contínuos com a nutrição e a atividade física. A recidiva de peso é verificada quando há retorno aos hábitos alimentares errôneos, sedentarismo e alto consumo alcoólico. OBJETIVO: Investigar nos pacientes submetidos à gastroplastia em Y-de- Roux a recidiva de peso, as deficiências nutricionais, os candidatos ao tratamento de plasma endoscópico de argônio e o diâmetro da anastomose gastrojejunal no momento da realização do tratamento com plasma. MÉTODOS: Estudo prospectivo não randomizado e sem grupo controle com 59 pacientes submetidos à gastroplastia, com recidiva de peso e candidatos ao procedimento endoscópico de plasma de argônio. A avaliação cirúrgica constou de investigação de complicações no aparelho digestório e verificação do aumento do diâmetro da anastomose gastrojejunal. A nutricional foi baseada no índice de massa corporal no momento da operação, o IMC mínimo que o paciente chegou após ela e o IMC em que se encontrava no momento de realizar procedimento com plasma. A análise laboratorial incluiu hemoglobina, volume globular, ferritina, vitaminas D, B12, ferro, cálcio, albumina sérica e zinco. A análise de seguimento baseou-se nos retornos programados. RESULTADOS: Dos 59 selecionados, cinco eram homens e 51 mulheres. Foram incluídos 49 pessoas (quatro homens e 44 mulheres) de ambos os sexos com todos os dados completos. A exclusão ocorreu pela falta de alguns dos exames laboratoriais. Deste total ao fazer o procedimento, 19 pacientes (38,7%) possuíam o anel restritivo, enquanto 30 (61,2%) não. Anemia ferropriva foi quadro comum; 30 pacientes (61,2%) encontravam-se com ferritina abaixo de 30 (unidade); 35 (71,4%) estavam com vitamina B12 abaixo de 300 pg/ml; deficiência de vitamina D3 ocorreu em mais de 90%; não houve casos de deficiência de proteínas, cálcio e zinco; glicemia estava acima de 99 mg/dl em três pacientes (6,12%). ...

Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Young Adult , Blood Glucose/analysis , Diabetes Mellitus/diagnosis , Data Collection , Diabetes Mellitus/epidemiology , Fasting/blood
Indian J Exp Biol ; 2014 Dec; 52(12): 1173-1181
Article in English | IMSEAR (South-East Asia), GHL | ID: sea-153808


In this study, we explored the effects of consumption of banana in thirty hypercholesterolemic and fifteen type 2 diabetic subjects. They were given a daily dose of 250 or 500 grams of banana for breakfast for 12 weeks. Fasting serum lipid, glucose and insulin levels were measured initially as well as every 4 weeks. Daily consumption of banana significantly lowered fasting blood glucose (from 99±7.7 to 92±6.9 and 102±7.3 to 92±5.7 mg∙dL-1 (p<0.05) after consuming banana 250 or 500 g/day for 4 wk, respectively) and LDL-cholesterol/HDL-cholesterol ratio (from 2.7±0.98 to 2.4±0.85 and 2.8±0.95 to 2.5±0.79, p<0.005) in hypercholesterolemic volunteers. Analysis of blood glycemic response after eating banana showed significantly lower 2 h-postprandial glucose level compared to baseline in hypercholesterolemic volunteers given a dose of 250 g/day. The changes of blood glucose and lipid profile in diabetic patients were not statistically significant, but for plasma levels of adiponectin, there were significantly increased (from 37.5±9.36 to 48.8±7.38 ng∙ml-1, p<0.05) compared to baseline. Although it remains to be confirmed with larger group of volunteers, this pilot study has demonstrated that daily consumption of banana (@ 250 g/day) is harmless both in diabetic and hypercholesterolemic volunteers and marginally beneficial to the later.

Adiponectin/blood , Adult , Antioxidants/administration & dosage , Blood Glucose/metabolism , Cholesterol, HDL/blood , Cholesterol, LDL/blood , Diabetes Mellitus, Type 2/blood , Eating/physiology , Fasting/blood , Female , Humans , Hypercholesterolemia/blood , Insulin/blood , Lipids/blood , Male , Middle Aged , Musa , Pilot Projects , Time Factors , Triglycerides/blood
Arq. bras. cardiol ; 103(3): 245-250, 09/2014. tab, graf
Article in English | LILACS (Americas) | ID: lil-723822


Background: Postprandial Lipemia (PPL) is a physiological process that reflects the ability of the body to metabolize lipids. Even though the influence of oral contraceptives (OC) on PPL is not known, it is a known fact that their use increases fasting lipid values. Objective: To compare the PPL between women who are on OC and those who are not. Methods: A prospective analytical study which assessed eutrophic women, aged between 18 and 28 years old, who were irregularly active and with fasting triglycerides ≤150 mg/dL. They were divided into two groups: oral contraceptive group (COG) and non-oral contraceptive group (NCOG). Volunteers were submitted to the PPL test, in which blood samples were collected in time 0 (12-hour fasting) and after the intake of lipids in times 180 and 240 minutes. In order to compare the triglyceride deltas, which reflect PPL, the two-tailed Mann-Whitney test was used for independent samples between fasting collections and 180 minutes (Δ1) and between fasting and 240 minutes (Δ2). Results: Forty women were assessed and equally divided between groups. In the fasting lipid profile, it was observed that HDL did not present significant differences and that triglycerides in COG were twice as high in comparison to NCOG. Medians of Δ1 and Δ2 presented significant differences in both comparisons (p ≤0.05). Conclusion: The results point out that women who are irregularly active and use OC present more PPL in relation to those who do not use OC, which suggests that in this population, its chronic use increases the risk of heart conditions. .

Fundamento: Lipemia pós-prandial (LPP) é um processo fisiológico que reflete a capacidade do organismo de metabolizar lipídeos. Embora não seja conhecida a influência dos contraceptivos orais (CO) na LPP, sabe-se que o seu uso eleva os valores lipídicos de jejum. Objetivo: Comparar LPP entre mulheres que utilizam e não utilizam CO. Métodos: Estudo analítico prospectivo, no qual foram avaliadas mulheres eutróficas, com idade entre 18 e 28 anos, irregularmente ativas e com triglicerídeos de jejum ≤150 mg/dL divididas em dois grupos: grupo contraceptivo (GCO) e grupo sem contraceptivo (GSCO). As voluntárias foram submetidas ao teste de LPP, no qual amostras sanguíneas foram coletadas no tempo 0 (jejum de 12 h) e após ingestão de lipídios nos tempos 180 e 240 minutos. Para comparação dos deltas dos triglicerídeos, que refletem a LPP, entre as coletas de jejum e 180 min (Δ1) e jejum e 240 min (Δ2), foi utilizado o teste de Mann-Whitney bidirecional para amostras independentes. Resultados: Foram avaliadas 40 mulheres divididas igualmente entre os grupos. No perfil lipídico de jejum, observou-se que a HDL não apresentou diferença significativa e que os triglicerídeos do GCO foram o dobro do GSCO. As medianas de Δ1 e Δ2 apresentaram diferença significativa nas duas comparações (p ≤0,05). Conclusão: Os resultados apontam que mulheres irregularmente ativas que utilizam CO apresentam LPP maior que aquelas que não utilizam CO, sugerindo que nessa população seu uso crônico aumenta o risco de doenças cardiovasculares. .

Adult , Female , Humans , Young Adult , Contraceptives, Oral/administration & dosage , Hyperlipidemias/blood , Lipids/blood , Postprandial Period/physiology , Age Factors , Body Mass Index , Cardiovascular Diseases/etiology , Cardiovascular Diseases/metabolism , Cholesterol, HDL/blood , Fasting/blood , Reference Values , Risk Factors , Statistics, Nonparametric , Surveys and Questionnaires , Time Factors , Triglycerides/blood
Rev. bras. cir. cardiovasc ; 29(3): 360-366, Jul-Sep/2014. tab
Article in English | LILACS (Americas) | ID: lil-727161


Objective: This study aims to investigate whether pre-operative Homeostasis Model Assessment Insulin Resistance (HOMA-IR) value is a predictor in non-diabetic coronary artery bypass grafting patients in combination with hemoglobin A1c, fasting blood glucose and insulin levels. Methods: Eighty one patients who were admitted to Cardiovascular Surgery Clinic at our hospital between August 2012 and January 2013 with a coronary artery bypass grafting indication were included. Patients were non-diabetic with <6.3% hemoglobin A1c and were divided into two groups including treatment and control groups according to normal insulin resistance (HOMA-IR<2.5, Group A; n=41) and high insulin resistance (HOMA-IR>2.5, Group B; n=40), respectively. Pre-operative fasting blood glucose and insulin were measured and serum chemistry tests were performed. The Homeostasis Model Assessment Insulin Resistance values were calculated. Statistical analysis was performed. Results: There was a statistically significant difference in fasting blood glucose and HOMA-IR values between the groups. Cross-clamping time, and cardiopulmonary bypass time were longer in Group B, compared to Group A (P=0.043 and P=0.031, respectively). Logistic regression analysis revealed that hemoglobin A1c was not a reliable determinant factor alone for pre-operative glucometabolic evaluation of non-diabetic patients. The risk factors of fasting blood glucose and cardiopulmonary bypass time were more associated with high Homeostasis Model Assessment Insulin Resistance levels. Conclusion: Our study results suggest that preoperative screening of non-diabetic patients with Homeostasis Model Assessment Insulin Resistance may improve both follow-up visit schedule and short-term outcomes, and may be useful in risk stratification of the high-risk population for impending health problems. .

Objetivo: Este estudo tem como objetivo investigar se a resistência de valor do Modelo de Avaliação da Homeostase da Resistência à Insulina (Homeostasis Model Assessment Insulin Resistance - HOMA-IR) no pré-operatório é um preditor de revascularização do miocárdio para pacientes não diabéticos em combinação com a hemoglobina A1c, glicemia em jejum e insulina. Métodos: Oitenta e um pacientes que foram internados no serviço de Cirurgia Cardiovascular em nosso hospital entre agosto de 2012 e janeiro de 2013, com indicação para cirurgia de revascularização do miocárdio indicação foram incluídos. Os pacientes não diabéticos com <6,3% de hemoglobina A1c foram divididos em dois grupos, incluindo os grupos de tratamento e controle de acordo com a resistência à insulina normal (HOMA-IR <2,5, Grupo A, n=41) e alta resistência à insulina (HOMA-IR> 2,5, Grupo B, n=40), respectivamente. Glicemia de jejum pré-operatório e insulina foram medidas e testes de química do soro foram realizados. Os valores de HOMA-IR foram calculados. A análise estatística foi realizada. Resultados: Houve diferença estatisticamente significativa em jejum de valores de glicose no sangue e HOMA-IR entre os grupos. Tempo de pinçamento e tempo de circulação extracorpórea foi maior no grupo B, em relação ao Grupo A (P=0,043 e P=0,031, respectivamente). A análise de regressão logística revelou que hemoglobina A1c não foi um fator determinante para a avaliação confiável sozinho glicometabólico pré-operatória de pacientes não diabéticos. Os fatores de risco de glicemia de jejum e tempo de circulação extracorpórea foram associados com altos níveis do HOMA-IR. Conclusão: ...

Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Coronary Artery Bypass , Homeostasis/physiology , Insulin Resistance/physiology , Risk Assessment/methods , Blood Glucose/analysis , Blood Glucose/physiology , Fasting/blood , Glycated Hemoglobin A/analysis , Insulin/blood , Logistic Models , Predictive Value of Tests , Preoperative Period , Reference Values , Reproducibility of Results , Risk Factors , Statistics, Nonparametric , Treatment Outcome
Clinics ; 69(8): 542-546, 8/2014. tab, graf
Article in English | LILACS (Americas) | ID: lil-718185


OBJECTIVE: Vitamin D deficiency has been related to diabetes, hypertension, hyperlipidemia and peripheral vascular disease. In this study, we aimed to investigate the role of vitamin D status in non-alcoholic fatty liver disease. METHODS: We included 211 consecutive subjects to examine the presence of non-alcoholic fatty liver disease. Of these subjects, 57 did not have non-alcoholic fatty liver disease and 154 had non-alcoholic fatty liver disease. RESULTS: The non-alcoholic fatty liver disease group had significantly higher fasting blood glucose (p = 0.005), uric acid (p = 0.001), aspartate aminotransferase (p<0.001), alanine aminotransferase (p<0.001), γ-glutamyltransferase (p<0.0001), alkaline phosphatase (p = 0.028), HbA1c (p<0.001), ferritin (p<0.001), insulin (p = 0.016), C-peptide (p = 0.001), HOMA-IR (p = 0.003), total cholesterol (p = 0.001), triglyceride (p = 0.001) and white blood cell (p = 0.04) levels. In contrast, the non-alcoholic fatty liver disease group had significantly lower 25(OH)D levels (12.3±8.9 ng/dl, p<0.001) compared with those of the control group (20±13.6 ng/dl). CONCLUSIONS: In this study, we found lower serum 25(OH)D levels in patients with non-alcoholic fatty liver disease than in subjects without non-alcoholic fatty liver disease. To establish causality between vitamin D and non-alcoholic fatty liver disease, further interventional studies with a long-term follow-up are needed. .

Adult , Female , Humans , Male , Middle Aged , Non-alcoholic Fatty Liver Disease/complications , Vitamin D Deficiency/complications , Vitamin D/blood , Albuminuria/urine , Blood Glucose/analysis , C-Peptide/blood , Creatinine/urine , Fasting/blood , Insulin/blood , Outpatients , Regression Analysis , Seasons , Vitamin D Deficiency/blood
Säo Paulo med. j ; 132(2): 97-104, 2014. tab, graf
Article in English | LILACS (Americas) | ID: lil-705381


CONTEXT AND OBJECTIVE: The thickness of the carotid intima-media complex (C-IMC) is considered to be a marker of early atherosclerosis, but visual and echogenic changes to the C-IMC can also be noted. The objective here was to evaluate the relationship between cardiovascular risk factors and the echogenicity of the C-IMC and identify those most associated with an "abnormal" C-IMC. DESIGN AND SETTING: Cross-sectional study in the ultrasound sector of the Department of Diagnostic Imaging, Universidade Federal de São Paulo. METHODS: Eighty men were evaluated. Measurements of arterial blood pressure, waist circumference (WC), lipid profile, fasting glucose, uric acid and high-sensitivity C-reactive protein were obtained. The thickness of the C-IMC was measured by means of B-mode ultrasound, and the intima-media gray-scale mean (IM-GSM) and standard deviation (IM-SD) were calculated. RESULTS: The following were discriminating variables: fasting glucose (r2 = 0.036; P = 0.013), uric acid (r2 = 0.08; P = 0.03), IM-SD (r2 = 0.43; P < 0.001), IM-GSM (r2 = 0.35; P < 0.001) and thickness of the C-IMC (r2 = 0.29; P < 0.001). IM-GSM showed significant correlations with WC (r = -0.22; P = 0.005), fasting glucose (r = -0.24; P = 0.002) and high-density lipoprotein cholesterol (HDL-C) (r = 0.27; P = 0.0007). CONCLUSION: IM-GSM showed correlations with WC, fasting glucose and HDL-C. However, uric acid and IM-SD presented the greatest discriminating impact. These results suggest that visual changes in C-IMC may help identify patients with potential cardiovascular risk, independently of the thickness of the C-IMC. .

CONTEXTO E OBJETIVO: A espessura do complexo íntima-média carotídeo (CIM-C) é considerada um marcador da aterosclerose precoce, mas alterações visuais e da ecogenicidade do CIM-C também podem ser observadas. O objetivo foi avaliar a relação entre os fatores de risco cardiovascular e a ecogenicidade do CIM-C e identificar aqueles mais relacionados com o CIM-C "alterado". TIPO DE ESTUDO E LOCAL: Estudo transversal no setor de ultrassonografia do Departamento de Diagnóstico por Imagem, Universidade Federal de São Paulo. MÉTODOS: Oitenta homens foram avaliados. Aferição da pressão arterial, medida da circunferência abdominal (CA), perfil lipídico, glicemia de jejum (GLI), ácido úrico (AU) e proteína C-reativa de alta sensibilidade foram obtidos. A espessura do CIM-C foi medida por ultrassom modo B e a média da escala de cinza (GSM) e do desvio padrão do CIM (DPIM) foram calculados. RESULTADOS: As variáveis discriminantes foram GLI (r2 = 0,036; P = 0,013), AU (r2 = 0,08; P = 0,03), DPIM (r2 = 0,43; P < 0,001), GSM (r2 = 0,35; P < 0,001) e espessura do CIM-C (r2 = 0.29; P < 0,001). Houve correlação significativa entre GSM e CA (r = -0,22; P = 0,005), GLI (r = -0,24; P = 0,002) e lipoproteína de alta densidade do colesterol (HDL-C) (r = 0,27; P = 0,0007). CONCLUSÃO: A GSM teve correlação com CA, GLI, HDL-C. Entretanto, AU e DPIM apresentaram maior impacto discriminante, sugerindo que alterações visuais do CIM-C, independentemente da espessura, podem auxiliar na identificação de pacientes com potencial risco cardiovascular. .

Adult , Humans , Male , Middle Aged , Carotid Intima-Media Thickness , Cardiovascular Diseases , Carotid Artery, Common , Metabolic Syndrome , Atherosclerosis/physiopathology , Atherosclerosis , C-Reactive Protein/analysis , Cross-Sectional Studies , Cardiovascular Diseases/etiology , Cardiovascular Diseases/physiopathology , Carotid Artery, Common/physiopathology , Fasting/blood , Glucose/metabolism , Lipoproteins, HDL/blood , Metabolic Syndrome/physiopathology , Reference Values , Risk Assessment , Risk Factors , Uric Acid/blood , Waist Circumference
Arq. bras. med. vet. zootec ; 65(6): 1685-1693, Dec. 2013. ilus, tab
Article in English | LILACS (Americas) | ID: lil-696849


The effects of different fasting periods on glycemia levels and on cardiorrespiratory parameters in tiletamine-zolazepam-anesthetized cats were evaluated. Twenty one animals were randomly assigned to three groups: 8 hours (G8), 12 hours (G12) or 18 hours (G18) of the preoperative fasting. The tiletamine-zolazepam (2 mg/kg) was administered intravenously. The heart rate (HR), respiratory rate (fR), rectal temperature (T R), glycemia (G), laboratorial glycemia (Glab), venous oxygen partial pressure (PvO2), venous carbon dioxide partial pressure (PvCO2), venous hemoglobin saturation (SvO2), pH, base deficit (BD), bicarbonate concentration (HCO3- ) and haematocrit were evaluated at 90 minutes after the last meal (T0), immediately before anesthesia (T1) and at ten (T2) and thirty (T3) minutes after tiletamine-zolezepam administration. The time between the administration of anesthetic and the cat's trial to elevate head (Th) and the interval between drug administration and aniamal's quadrupedal position (Tqp) were recorded. No differences among groups were recorded for glycemia, HR, PvO2, SvO2, pH, BD, HCO3-, Ht and Tqp. In G12 from T2, glycemia increased and from T1 PvCO2 decreased. At T1, PvO2 increased in all groups. In G8 and G12, from T1, DB and HCO3- decreased. In G12 and G18, from T2, Ht decreased. In G12, the Th mean was higher than G8. In conclusion, in tiletamine-zolazepam-anesthetized cats, the different preoperative fasting did not influence glycemia, blood-gas and cardiorrespiratory parameters. Additionally, there was no relationship between glycemia and anesthesia recovery.

Avaliaram-se os efeitos de diferentes períodos de jejum sobre os níveis glicêmicos e os parâmetros cardiorrespiratórios em gatos anestesiados com tiletamina-zolazepam. Vinte um animais foram distribuídos aleatoriamente em três grupos diferenciados entre si pelo período de jejum: oito horas (G8), doze horas (G12) e dezoito horas (G18). A tiletamina-zolazepam (2mg/kg) foi administrada por via intravenosa. A frequência cardíaca (FC), frequência respiratória (fR), temperatura retal (TR), glicemia, glicemia laboratorial (Glab), pressões parciais de oxigênio (PvO2) e dióxido de carbono (PvCO2) no sangue venoso, saturação de hemoglobina do sangue venosos (SvO2), pH, déficit de base (DB), bicarbonato (HCO3-) e hematócrito (Ht) foram mensurados 90 minutos após a última refeição (T0), imediatamente antes da anestesia (T1) e 10 (T2) e 30 (T3) minutos após a administração do anestésico. Foram avaliados os períodos entre a administração do anestésico e a tentativa dos gatos de levantar a cabeça (Th) e o intervalo de tempo entre a administração do anestésico e o posicionamento quadrupedal (Tpq) do animal. Diferenças entre os grupos não foram registradas para glicemia, HR, PvO2, SvO2, pH, BD, HCO3-, Ht e Tpq. No G12, a partir de T1 e T2, a PvCO2diminuiu e a glicemia aumentou, respectivamente. No G8 e G12, a partir de T1, DB e HCO3-diminuíram. No G12 e no G18, a partir de T2, Ht diminui. O Th no G12 foi maior que no G8. Conclui-se que, em gatos anestesiados com tiletamina-zolazepam, os diferentes períodos de jejum não influenciaram na glicemia, nos parâmetros hemagosométricos e cardiorrespiratórios. Adicionalmente, não há correlação entre a glicemia e a recuperação anestésica.

Animals , Cats , Anesthesia , Blood Glucose/analysis , Fasting/blood , Cats/classification , Tiletamine/administration & dosage
Braz. j. infect. dis ; 17(4): 438-443, July-Aug. 2013. tab
Article in English | LILACS (Americas) | ID: lil-683131


OBJECTIVE: To evaluate the cumulative incidence of dyslipidemia and fasting glucose impairment three years after initiating the first antiretroviral (ART) regimen and the association with the type of ART regimen in an AIDS outpatient clinic in Brazil. METHODS: Retrospective cohort of HIV-1 infected patients attending an outpatient HIV clinic in Vitoria, Brazil, between January/2010 and May/2011. Data, including blood pressure, dyslipidemia (high total cholesterol and low HDL-C), fasting glucose, and cardiovascular risk by Framingham Risk Score were abstracted from medical records from clinic visits six months prior and three years after starting ART. We assessed independent associated factors for dyslipidemia using multiple logistic regression. RESULTS: Four hundred and ninety-eight patients on ART were studied. Median age was 45 years (interquartile range (IQR): 37-52), and median time since HIV diagnosis was 7.7 years (IQR: 3.8-10.0). The proportion of patients with dyslipidemia was 22.3% (95% CI: 18.6-25.9%) 36 months after ART initiation. Triglycerides levels >150 mg/dL (55.2% vs. 25.4%, p = 0.021) and high fasting glucose (5.8% vs. 2.3%, p = 0.034) were diagnosed more frequently after ART use when compared to baseline values. Multiple logistic regression analysis has shown dyslipidemia to be associated with lopinavir/r use [OR = 1.74 (95% CI: 1.12-2.86)]. CONCLUSION: These data show high chance of dyslipidemia after initiation of ART. Long-term follow-up will help identify the impact of ART on cardiovascular risk.

Adult , Female , Humans , Male , Middle Aged , Anti-HIV Agents/adverse effects , Blood Glucose/metabolism , Dyslipidemias/etiology , Fasting/blood , HIV Infections/drug therapy , Ambulatory Care Facilities , Anti-HIV Agents/therapeutic use , Brazil , Cohort Studies , Dyslipidemias/diagnosis , HIV Infections/blood , HIV Infections/complications , Retrospective Studies , Risk Factors
Article in English | IMSEAR (South-East Asia), GHL | ID: sea-163292


Aim of the Study: This study investigates the effects of Capsicum frutescens supplemented diet (C.F.S.D) on fasting blood glucose level, biochemical parameters and body weight in alloxan induced diabetic Wistar rats. Experimental Design: 130 – 150g healthy forty male Wistar rats were divided into four groups as following; Group 1 served as a normal control and received normal feed-. Group 2 (Diabetic control) received normal feed-. Group 3 (Diabetic test 1) received normal feed + 1g Capsicum frutescens.-. Group 4 (Diabetic test 2) received normal feed + 2g Capsicum frutescens. Place and Duration of Study: This study was carried out in the department of Physiology, Faculty of Basic Medical Sciences, Delta State University, Abraka and the feeding lasted for three weeks. At the end of the experiments, the animals were sacrificed, blood samples were collected and then the serum was further subjected to biochemical analysis using biochemical analyzer (Reflotron Plus). Results: AST, ALT, ALP, GGT, Creatinine, Uric acid, total cholesterol and fasting blood sugar level in serum were increased however the high density lipoprotein cholesterol (HDL-c) of serum was decreased in diabetic control (group 2), compared with non-diabetic control (group 1). The administered Capsicum frutescens in the diet at 1g and 2g doses significantly reduced the fasting blood glucose level as well as the serum level of AST, ALT, ALP, GGT, Creatinine, Uric acid, total cholesterol, compared with diabetic control. Serum HDL was also significantly increased when compared with diabetic control P<0.05. Decrease in body weight in diabetic control group and increased in body weight of 1gand 2g Capsicum frutescens supplemented diet groups were also observed. Conclusion: The observed improvement in the biochemical parameters, blood glucose levels and body weight of alloxan induced diabetic Wistar rats by 1g and 2g Capsicum frutescens supplemented diet suggests Capsicum frutescens to possess, cardioprotective and anti-diabetic properties. Recommendation: The incorporation of Capsicum frutescens as spice in the diet of individuals who are diabetic, hypertensive and obese, is worthy of recommendation.

Alloxan/adverse effects , Animals , Body Weight/metabolism , Capsicum , Glucose/metabolism , Fasting/blood , Food, Fortified , Diabetes Mellitus, Experimental/chemically induced , Liver/enzymology , Rats, Wistar/metabolism , Rats, Wistar/physiology , Thermogenesis
Arq. bras. endocrinol. metab ; 57(5): 381-387, jul. 2013. tab
Article in Portuguese | LILACS (Americas) | ID: lil-680626


OBJETIVO: O presente estudo visa testar a possibilidade de que indivíduos não diabéticos, com glicemia de jejum < 126 mg/dL e com HbA1c alterada, já apresentem diminuição na filtração glomerular estimada (FGe) e aumento do MCP-1, em comparação com aqueles com HbA1c normal, independente de outras alterações metabólicas. MATERIAIS E MÉTODOS: Este estudo utilizou dados do Estudo CAMELIA (cardiometabólico renal familiar), de julho de 2006 a dezembro de 2007, com visitas aos módulos do Programa Médico de Família (PMF) de Niterói, RJ. RESULTADOS: Verificamos associação independente entre a alteração da HbA1c (≥ 5,7 e < 6,5% versus < 5,7%) e diminuição da taxa de filtração glomerular estimada. A HbA1c mostrou ser um marcador subclínico de alterações metabólicas em pacientes não diabéticos e com glicemia de jejum < 126 mg/dL, em especial na população de mulheres e de indivíduos com a cor da pele preta. CONCLUSÃO: Essas observações indicam a possibilidade de se utilizar a HbA1c no intuito de se triar grupos de risco, visando propor estratégias de intervenção precoce e, assim, promover a prevenção de doenças crônicas, como diabetes e doença renal crônica.

OBJECTIVE: This study aims investigate if nondiabetic subjects with fasting glucose < 126 mg/dL but altered HbA1c already have lower estimated glomerular filtration (eGFR) and high serum MCP-1 levels in comparison to nondiabetics with normal HbA1c, independent of other metabolic changes. MATERIALS AND METHODS: Data were derived from the database of the CAMELIA (cardio-metabolic-renal family) study, a cross sectional study performed between July 2006 and December 2007, with participants recruited from the Family Doctor Program, Niterói, RJ. RESULTS: An independent association between changes in HbA1c (≥ 5.7 and < 6.5% versus < 5.7%) and decreased eGFR rate was found. The HbA1c was shown to be a marker of metabolic changes in nondiabetic subjects with fasting glucose < 126 mg/dL, particularly in women and blacks. CONCLUSION: These observations support the use of HbA1c levels in strategies for early intervention and prevention of chronic diseases such as diabetes mellitus and chronic kidney disease.

Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Young Adult , Blood Glucose/analysis , /blood , Creatinine/analysis , Fasting/blood , Glomerular Filtration Rate/physiology , Glycated Hemoglobin A/analysis , Body Mass Index , Biomarkers/blood , Biomarkers/urine , Glucose Tolerance Test , Life Style , Sodium/urine
Invest. clín ; 54(2): 149-160, jun. 2013. tab
Article in Spanish | LILACS (Americas) | ID: lil-740344


El incremento de la adiposidad, conduce a un deterioro de la tolerancia a la glucosa y de la acción de la insulina. Se determinó la resistencia a la insulina (RI) por métodos indirectos y se correlacionó con variables clínicas, antropométricas y bioquímicas en escolares obesos normoglicémicos. Estudio descriptivo-correlacional, realizado en 72 escolares, que acudieron al ambulatorio El Concejo de la Universidad de Carabobo (UC) y al servicio de Gastroenterología y Nutrición Pediátrica de la Ciudad Hospitalaria “Enrique Tejera” (CHET), de Valencia, Venezuela, entre enero y abril de 2011. Criterio de Inclusión: obesidad exógena. Se evaluaron antecedentes personales y familiares, presencia de acantosis nigricans y valoración nutricional y bioquímica. Se encontró mayor porcentaje de RI, a través de la utilización del método QUICKI (66,7%), seguido del HOMA (55,6%) y la insulina basal (45,9%). Las medias de índice de masa corporal y circunferencia de cintura, fueron significativamente mayores (p<0,05), en pacientes con RI, estimadas por los métodos HOMA y QUICKI. El método QUICKI, detectó diferencias significativas (p<0,05), entre las glicemias e insulinas basales y entre las insulinas postprandiales, de los pacientes con sensibilidades insulínica disminuida y normal; mientras que el HOMA, detectó estas diferencias (p<0,05), en las glicemias e insulinas basales. Se observó una correlación estadísticamente significativa (p<0,05), entre la presencia de acantosis nigricans y la RI, estimada por los métodos HOMA, QUICKI e insulina basal. En conclusión, de los métodos evaluados, los índices QUICKI, HOMA y la insulina basal, fueron los más eficaces para detectar la RI.

Obesity leads to a deterioration of glucose tolerance and the action of insulin. The purpose of this study was to determine insulin resistance (IR) by indirect methods, and its correlation with clinical, anthropometric and biochemical variables in obese normoglycemic school children. This was a descriptive-correlational study of 72 school prepubescent children, who attended the ambulatory “El Concejo” of the University of Carabobo (UC) and at the Gastroenterology and Pediatric Nutrition service of the city hospital “Enrique Tejera” (CHET), in Valencia, Venezuela, between January-April 2011. Inclusion criteria: exogenous obesity. We assessed personal and family history, presence of Acanthosis Nigricans and nutritional and biochemical status. We found a higher percentage of IR, through the use of the QUICKI method (66.7%), followed by the HOMA (55.6%) and basal insulin (45.9%). The mean (c) indexes of body mass and waist circumference were significantly greater (p < 0.05) in patients with IR, by HOMA and QUICKI techniques. The QUICKI method detected significant differences (p < 0.05) in the values of glycemia, basal insulin and postprandial insulin, among patients with diminished and normal insulin sensitivities. While HOMA, detected these differences (p < 0.05) in the values of glycemia and basal insulin. A statistically significant relationship was observed (p < 0.05), between the presence of Acanthosis Nigricans and IR, by the HOMA, QUICKI and basal insulin methods. In conclusion, the evaluated techniques, QUICKI, HOMA and basal insulin indexes, were most effective for detecting the IR.

Child , Female , Humans , Male , Insulin Resistance , Obesity/blood , Acanthosis Nigricans/blood , Acanthosis Nigricans/epidemiology , Body Composition , Body Mass Index , Blood Glucose/analysis , Checklist , /genetics , Fasting/blood , Homeostasis , Insulin/blood , Insulin , Lipids/blood , Models, Biological , Nutritional Status , Postprandial Period , Thigh/anatomy & histology , Venezuela/epidemiology , Waist Circumference
Clinics ; 68(3): 379-383, 2013. graf, tab
Article in English | LILACS (Americas) | ID: lil-671430


OBJECTIVE: Fetuin-A is a protein secreted from the liver that inhibits arterial calcification deposition and can contribute to insulin resistance. Hyperthyroidism is also associated with insulin resistance. It is not known whether hyperthyroidism has an effect on fetuin-A levels. METHODS: We measured fetuin-A levels and homeostasis model of assessment-insulin resistance before hyperthyroidism treatment was initiated and after euthyroidism was achieved. A total of 42 patients diagnosed with hyperthyroidism were enrolled in this study. Fetuin-A, insulin, high-sensitivity C-reactive protein, fasting blood glucose, free T3 (fT3), free T4 (fT4), and thyrotropin were measured before and after euthyroidism was established. RESULTS: Basal fasting blood glucose, high-sensitivity C-reactive protein, insulin, c-peptide, homeostasis model of assessment-insulin resistance, fT3, fT4 and fetuin-A levels were significantly decreased after euthyroidism was achieved (Table 1). Basal fasting blood glucose (r:0.407, p:0.008), high-sensitivity C-reactive protein (r:0.523, p<0.0001), insulin (r:0.479, p:0.001), homeostasis model of assessment-insulin resistance (r:0.541, p<0.0001), fT3 (r:0.492, p:0.001) and fT4 (r:0.473, p:0.002) were positively correlated with basal fetuin-A levels. Basal thyrotropin levels were significantly negatively correlated (r:-0.553, p<0.0001) with basal fetuin-A levels. CONCLUSION: Our findings suggest that hyperthyroidism influences fetuin-A levels.

Adult , Animals , Female , Humans , Male , Middle Aged , Hyperthyroidism/blood , /analysis , Blood Glucose/analysis , Enzyme-Linked Immunosorbent Assay , Fasting/blood , Insulin Resistance/physiology , Thyroid Function Tests , Thyrotropin/blood
Clinics ; 68(3): 427-430, 2013. tab
Article in English | LILACS (Americas) | ID: lil-671440


OBJECTIVE: To evaluate the effects of the levels of glycemic control on the frequency of clinical complications following invasive dental treatments in type 2 diabetic patients and suggest appropriate levels of fasting blood glucose and glycated hemoglobin considered to be safe to avoid these complications. METHOD: Type 2 diabetic patients and non-diabetic patients were selected and divided into three groups. Group I consisted of 13 type 2 diabetic patients with adequate glycemic control (fasting blood glucose levels <140 mg/dl and glycated hemoglobin (HbA1c) levels <7%). Group II consisted of 15 type 2 diabetic patients with inadequate glycemic control (fasting blood glucose levels >140 mg/dl and HbA1c levels >7%). Group III consisted of 18 non-diabetic patients (no symptoms and fasting blood glucose levels <100 mg/dl). The levels of fasting blood glucose, glycated HbA1c, and fingerstick capillary glycemia were evaluated in diabetic patients prior to performing dental procedures. Seven days after the dental procedure, the frequency of clinical complications (surgery site infections and systemic infections) was examined and compared between the three study groups. In addition, correlations between the occurrence of these outcomes and the glycemic control of diabetes mellitus were evaluated. RESULTS: The frequency of clinical outcomes was low (4/43; 8.6%), and no significant differences between the outcome frequencies of the various study groups were observed (p>0.05). However, a significant association was observed between clinical complications and dental extractions (p = 0.02). CONCLUSIONS: Because of the low frequency of clinical outcomes, it was not possible to determine whether fasting blood glucose or glycated HbA1c levels are important for these clinical outcomes.

Adult , Female , Humans , Male , Middle Aged , Biomarkers/blood , Blood Glucose/analysis , /blood , Glycated Hemoglobin A/analysis , Oral Surgical Procedures/adverse effects , Postoperative Complications/blood , Case-Control Studies , Fasting/blood , Predictive Value of Tests , Reference Values